Anatomy and Physical Examination of the Shoulder

The shoulder is a complex joint, with a wide range of motion and functional demands. An understanding of the intricate network of bony, ligamentous, muscular, and neurovascular anatomy is required in order to properly identify and diagnose shoulder pathology. There exist many articulations, unique structural features, and anatomic relationships that play a role in shoulder function, and therefore, dysfunction and injury. Evaluation of a patient with shoulder complaints is largely reliant upon physical exam. As with any exam, the basic tenets of inspection, palpation, range of motion, strength, and neurovascular integrity must be followed. However, with the degree of complexity associated with shoulder anatomy, specific exam maneuvers must be utilized to isolate and help differentiate pathologies. Evaluation of rotator cuff injury, shoulder instability, or impingement via exam guides clinical decision-making and informs treatment options.